Nonselective beta blockers and alcohol create serious drug interactions with insulin because they:
- A. Increase blood glucose levels
- B. Produce unexplained diaphoresis
- C. Interfere with the ability of the body to metabolize glucose
- D. Mask the signs and symptoms of altered glucose levels
Correct Answer: D
Rationale: Nonselective beta blockers and alcohol mask hypoglycemia symptoms (e.g., tachycardia), complicating detection.
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The patient, diagnosed with cancer, is receiving morphine sulfate (a potent narcotic pain reliever) to relieve cancer pain. Approximately every 7 days the medication is no longer effective in controlling the patient's pain and a larger dose is needed to have the same effect. How might the nurse explain why this is happening?
- A. Tolerance
- B. Cumulation
- C. Interactions
- D. Addiction
Correct Answer: A
Rationale: The body may develop a tolerance to some drugs over time. Tolerance may arise because of increased biotransformation of the drug, increased resistance to its effects, or other pharmacokinetic factors. When tolerance occurs, the amount of the drug no longer causes the same reaction. Therefore, increasingly larger doses are needed to achieve a therapeutic effect. Cumulative effect occurs when the drug is not properly eliminated and more of the drug is administered, resulting in toxic levels accumulating. Interactions occur when the drug reacts badly with another substance such as food, another drug, or an alternative or complementary therapy. Addiction is the psychological need for a substance.
A nurse is providing teaching to a client who has a new prescription for Clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects?
- A. Diarrhea
- B. Dry mouth
- C. Insomnia
- D. Hypertension
Correct Answer: B
Rationale: Clonidine commonly causes dry mouth due to its anticholinergic effects.
The average starting dose of warfarin is 5 mg daily. Higher doses of 7.5 mg daily should be considered in which patients?
- A. Pregnant women
- B. Elderly men
- C. Overweight or obese patients
- D. Patients with multiple comorbidities
Correct Answer: C
Rationale: Overweight/obese patients may need higher warfarin doses due to larger volume of distribution; pregnancy contraindicates warfarin.
When using a bar-code point-of-care medication system, the nurse would scan which of the following prior to drug administration?(Select one that does not apply.)
- A. Client's hospital chart
- B. Client's identification band
- C. Drug unit dose package
- D. Nurse's identification badge
Correct Answer: A
Rationale: The bar-code point-of-care medication system requires that the client's identification band, the drug unit dose package, and the nurse's identification badge are all scanned prior to drug administration.
Which name identifies a drug listed by the US Food and Drug Administration (FDA)?
- A. Brand
- B. Nonproprietary
- C. Official
- D. Trademark
Correct Answer: C
Rationale: The official name is the name under which a drug is listed by the FDA. The brand name, or trademark, is the name given to a drug by its manufacturer. The nonproprietary, or generic, name is provided by the United States Adopted Names Council.
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